What is Vaginal Prolapse?

Vaginal prolapse has many similarities to hernias. They are both due to weakness of the supporting tissues. Genital prolapse is due to weakness of the pelvic floor. The pelvic floor is composed of muscles, collagen, connective tissue and fascia. A weakness of these supporting tissues allows the tissues and organs surrounding the vagina to herniate into the vagina resulting in prolapse. The following figure represents the normal relationship between the pelvic floor and the organs.

Prolapse is named after the tissue or organ that has lost its support and is protruding into the vagina. For example when the urethra protrudes into the vagina this is called a urethrocele. If the bladder prolapses this is called a cystocele.

Prolapse of the uterus is uterine prolapse. Prolapse of the peritoneum or small bowel is called enterocele.

Prolapse of the rectum is referred to as rectocele. A rectocele is the bulging of the rectum forward into the vagina.

Lack of support of the perineum (the area between the entrance of the vagina and anus) causes a deficiency rather than a prolapse.

If the uterus has been removed and the top of the vagina protrudes this is referred to as a vault prolapse. Multiple sites of vaginal prolapse commonly exist together and vaginal inversion is where the majority of the vagina protrudes outside.

Rectal prolapse is prolapse of the rectum (picture rectal prolapse) through the anus and urethral prolapse is prolapse of the urethra through the urinary outlet.